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The House-Brackmann Facial Nerve Grading Scale

Grade Function
I Normal
  1. Normal at rest. 
  2. Slight weakness on close inspection. 
  3. Complete eye closure with minimal effort. 
  4. Slight asymmetry of mouth with movement. 
  5. Good to moderate forehead movement
  1. Normal at rest. 
  2. Obvious asymmetry on movement. 
  3. Synkinesis ± hemifacial spasm. 
  4. Complete eye closure with effort. 
  5. Slight to moderate forehead movement. 
  6. Slight weakness of mouth with maximal effort
  1. Normal at rest. 
  2. Asymmetry on movement is disfiguring. 
  3. Incomplete eye closure. 
  4. No perceptible forehead movement. 
  5. Asymmetrical mouth motion with maximal effort
  1. Asymmetric at rest. 
  2. Barely noticeable movement. 
  3. No forehead movement. 
  4. Incomplete eye closure. 
  5. Slight mouth movement with effort
VI No facial function perceptible

Davidson's Principles and Practice of Medicine 20th Edition (Churchill Livingstone) 2007

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